Plan Detail

Plan Administrator: Independence Holding Company IHC | AM Best Rating: A-"Excellent" | Underwriter: Independence American Insurance Company, Madison National Life Insurance Company, and Standard Security Life Insurance Company of New York.

Fusion STM is short-term medical insurance that provides financial protection in the event of an unexpected injury or illness. While Fusion provides first-dollar benefits, Fusion STM is designed to offer additional coverage for large expenses

Description

Eligibility

If you are a dues-paying member of America’s Business Benefit Association (ABBA), 18 to 64-and-a-half years of age and a permanent resident of the United States, you and your eligible dependents may apply to purchase the Fusion Plan. You can apply by completing an application for insurance; you and your eligible dependents, if applying, must qualify for coverage based on the plan’s underwriting guidelines. Eligible dependents include your lawful spouse/domestic partner under 64-and-a-half years of age, and your unmarried child(ren) under age 26.

Effective date

You may request that your coverage become effective on a future date that is not more than 60 days after the application date, including the next day following the application date. We must receive your application before the requested effective date. If your application is approved, your coverage will become effective on the requested effective date following approval. Your applicable premium must be paid before your coverage under the Policy goes into effect. If the company is unable to approve your application within 60 days of the application date, the requested effective date will not be honored and a new, currently dated application may be required.

Precertification

Precertification is a screening process used to determine if the proposed inpatient confinement, outpatient chemotherapy or radiation treatment is medically necessary and appropriate. Failure to obtain the required precertification will result in no benefits being paid. Precertification is required at least seven days prior to each non-emergency inpatient confinement and within 48 hours of inpatient admission or as soon as reasonably possible for emergency inpatient confinement. Precertification is also required seven days prior to receiving outpatient chemotherapy and radiation therapy. Precertification is not pre-authorization or pre-approval of coverage and it does not guarantee payment of benefits. Payment of benefits will be determined in accordance with and subject to all the terms, conditions, limitations and exclusions of the Policy.